Dzimwe nguva unonzwa kubatwa kana kurwadziwa muchipfuva chako here? Kana kuti unoomerwa nekufema kana waneta zvishoma? Izvi zvinogona kuva zviratidzo zvetsinga dzeropa dziri mumoyo medu (coronary arteries) dzichivharika zvishoma nezvishoma. Zvakafanana netsvina iri kuungana mukati mepombi yemvura mumba medu uye ichivharika zvishoma nezvishoma. Kana izvi zvikasarapwa, zvinogona kutokonzera kurwara nemoyo. Asi usazvidya moyo, mushonga wemazuva ano une mishonga inoshanda zvikuru yeizvi. Nhasi tichataura nezvenzira yekurapa inogona kumutsiridza moyo wakadaro.
Chii chinonzi Coronary Revascularization iyi?
Izvi zvinganzwika sezwi refu, risinganzwisisike, asi zvarinoreva zviri nyore kwazvo. "Coronary" zvinoreva mitsipa yeropa inobatana nemoyo. "Revascularization" zvinoreva "kudzoreredza kuyerera kweropa." Saka, muchidimbu, Coronary Revascularization mushonga unodzosera kuyerera kweropa kumoyo kana tsandanyama yemoyo isiri kuwana ropa rayo (chirwere chatinodaidza kuti ischemia mukurapa) . Kungave nekuvhurazve mitsipa yeropa yakavharika kana nekugadzira nzira itsva yekutenderedza kuvharika.
Kurapa uku kunogona kuderedza kukuvara kwemoyo wako mushure mekurwara nemoyo, uye kunogonawo kudzivirira kana uri panjodzi huru yekurwara nemoyo.
Tiri kutaura nezvenzira mbiri dzekurapa pasi peizvi:
1. Percutaneous Coronary Intervention (PCI): Izvi ndizvo zvinonzi nevanhu vazhinji "kuisa stent." Izvi zvinosanganisira kupinda mutsinga yeropa, kubvisa kuvharika, uye kugadzira nzira yekuti ropa riyerere, pasina kuvhiyiwa.
2. Coronary Artery Bypass Grafting (CABG): Izvi zvinozivikanwawo se "Bypass Surgery." Izvi zvinosanganisira kugadzira nzira itsva (bypass) inotenderedza tsinga yeropa yakavharika uchishandisa chidimbu chetsinga yeropa chakatorwa kubva kune imwe nhengo yemuviri.
| Nzira yekurapa | Zvichitaurwa zviri nyore... |
|---|---|
| PCI (kuiswa kwestent) | Zvakafanana nekuisa waya mupombi yakavharika, woiputitsa, wogadzirisa mugwagwa. Hapana kukuvara kukuru. |
| CABG (Kuvhiyiwa kweBypass) | Kufanana nekuvaka nzira itsva yekupfuura mugwagwa une vanhu vakawanda, nzira itsva yeropa inoiswa panzvimbo imwe chete kuti ipfuure nzira yeropa yakavharika. Uku kuvhiyiwa. |
Ndiani anoda kurapwa uku?
Munhu wese ane ropa shoma rinoyerera kuenda kumoyo anogona kubatsirwa nemishonga iyi. Chikonzero chikuru cheizvi chirwere chemwoyo . Njodzi yechirwere ichi inowedzera nekukura. Saka, vanhu vane makore anopfuura 65 ndivo vanowanzoda kurapwa uku zvakanyanya.
Fungidzira, chinhu chakakora chakagadzirwa nemafuta necholesterol (tinoti plaque) chinoungana zvishoma nezvishoma mukati metsinga dzedu dzeropa. Maitiro aya anonzi atherosclerosis . Zvakafanana nemafuta anonamira mupombi yekubikira yekicheni ovharika. Nekufamba kwenguva, kuvharika uku kunoita kuti tsinga yeropa itete. Kana rimwe zuva kuvharika uku kukabuda, ropa rinogona kuumbwa panzvimbo iyoyo rovhara tsinga yeropa zvachose. Ndipo apo chikamu chemoyo chinomira kuwana ropa, zvichikonzera kurwara kwemoyo.
Saka, kune vanhu vane rudzi urwu rwekuvharika, mushonga uyu unoshandiswa kukurumidza kudzorera kuyerera kweropa masero emwoyo asati afa.
Ndezvipi zvirwere zvinorapwa nemishonga iyi?
Kurapa uku kunonyanya kushandiswa kune zvirwere zviri muchikamu che acute coronary syndrome. Izvi zvinoreva:
- Kurwara nemoyo: Kukuvara kwetsandanyama yemoyo nekuda kwekuvharika kwetsinga yeropa kamwe kamwe.
- Angina Yakagadzikana: Chirwere chinorwadza pachipfuva panguva yekurovedza muviri, senge pakukwira masitepisi, uye chinodzikira paunenge wakazorora.
- Angina isina kugadzikana: Chirwere chine njodzi chinoratidzwa nekurwadziwa pachipfuva kunowedzera kunyangwe wakazorora.
Chii chinoitika usati warapwa?
Kana wangosarudza kuita imwe yemishonga iyi, vanachiremba vachakuitira bvunzo dzakawanda kuti vaongorore mamiriro ako ezvinhu nemazvo uye varonge nzira yakanakisisa yekurapwa.
| Bvunzo | Unongoita sei? |
|---|---|
| Electrocardiogram (ECG kana EKG) | Kushanda kwemagetsi kwemoyo kunoongororwa. |
| Echocardiogram | Zvakafanana nekuskena, kutarisa mashandiro uye saizi yemoyo. |
| Kuisa katheta mumoyo / Angiogram | Mvura yakakosha inopinzwa mutsinga dzeropa uye X-ray inotorwa kuti ionekwe kuti yakavharwa kupi uye yakawanda sei. |
| Angiography yeCT scan | Kuongororwa kweCT kunoongorora kana paine tsinga dzeropa dzakavharika. |
| Kuongororwa kweropa | Zvinhu zvakaita sema enzymes ne cholesterol mazinga zvinoongororwa kuti zvionekwe kana moyo wakakuvara. |
Kunze kwekunge paine emergency, uchafanirwa kutsanya kwemaawa angangoita masere usati watanga kuvhiyiwa. Usati watanga kuvhiyiwa, muchina we IV (chubhu inokupa saline) uchaiswa mutsinga iri muruoko rwako. Apa ndipo pachapihwa mishonga nemvura zvinodiwa mumuviri wako. Kana uri PCI, uchapihwa mushonga wekunyaradza. Kana uri kuvhiyiwa neCABG bypass, uchaiswa pasi peanesthesia.
Chii chinoitika panguva yekurapwa?
Kunyange zvazvo chinangwa chePCI neCABG chakafanana, maitiro azvinoitwa akasiyana zvikuru.
Maitiro ekuisa stent paPCI (PCI)
Pano, chiremba anoisa chubhu yakatetepa uye inochinjika (catheter) mutsinga huru yeropa, kungave kuburikidza neruoko rwako kana chiuno. Chubhu yacho inozotungamirirwa kutsinga yeropa yakavharika iri mumoyo mako ichitungamirirwa neX-ray.
Tevere, bharumu diki riri kumagumo kwechubhu rinofuridzirwa panzvimbo yakavharika. Izvi zvinoita kuti tsinga yeropa yakamanikana ikure kubva mukati. Izvi zvinonzi barumu angioplasty .
Fungidzira, zvinoitika pano zvakafanana nekuisa bharumu mupombi yakavharika woiputitsa, uchisundira ivhu riri mukati mepombi kumativi ese, zvichigadzira mugwagwa.
Zvadaro, kuti tsinga yeropa yakakurisa isatsvedzerere zvakare, furemu diki yesimbi yakagadzirwa semesh inoiswa panzvimbo yayo. Izvi ndizvo zvatinodaidza kuti stent . Mamwe ma stents ane mushonga mukati mawo unodzivirira tsinga yeropa kuti isatsvedzerere zvakare. Aya anonzi ma drug-eluting stents . Mushure mekunge basa rapera, chubhu inobviswa, shonji diki inoiswa payakaiswa, uye kurapwa kwapera.
Nzira yeCABG (Bypass Surgery)
Uku kuvhiyiwa. Chiremba anovhiya anotanga atora chidimbu chetsinga yeropa ine hutano kubva kune imwe nzvimbo mumuviri wako (kazhinji kubva pagumbo rako, ruoko, kana mukati mechipfuva chako).
Mushure meizvozvo, mwoyo unosvikwa nenzira mbiri:
- Kuvhiyiwa kwakavhurika: Kuchekwa kunochekwa masendimita akati wandei kubva pakati pechipfuva, kuchivhura pfupa rechipfuva (sternum) kuti risvike pamoyo.
- Kuvhiyiwa kusingakuvadzi zvakanyanya: Izvi zvinosanganisira kucheka kamwe chete kana kupfuura chipfuva uye kushandisa kamera nezvimwe zvinhu zvakakosha kusvika pamoyo nepambabvu. Dzimwe nguva izvi zvinoitwa nekuvhiyiwa kwemarobhoti.
Panguva yekuvhiyiwa, moyo unogona kumira kwenguva pfupi wobatanidzwa nemuchina we heart -lung bypass kuti uite basa racho. Zvisinei, mamwe maoparesheni anoitwa mwoyo uchiri kurova (off-pump bypass).
Chiremba anozoshandisa tsinga yeropa yakambobviswa kugadzira nzira itsva nekubatanidza tsinga yeropa yakavharika iri pamusoro nepasi payo. Zvakafanana nekugadzira nzira itsva yekupfuura mugwagwa une vanhu vakawanda. Izvi zvinodzivisa kuvharika uye zvinobvumira ropa kuti riyerere mutsandanyama yemwoyo munzira itsva. Kana nzira yekupfuura yapera, chipfuva chinovharwa, masitichi anosonerwa, uye kuvhiyiwa kwapera.
Chii chinoitika mushure mekurapwa?
Uchada nguva yekupora mushure mekuvhiyiwa. Nguva ino inoenderana nerudzi rwekuvhiyiwa kwawakaitwa (PCI kana CABG) uye hutano hwako hwese. Kazhinji, unodzokera kune zvakajairika mukati memazuva mashoma mushure mekuvhiyiwa kwePCI. Zvisinei, zvinogona kutora mavhiki akati wandei kana mwedzi yakati wandei mushure mekuvhiyiwa kweCABG.
Paunenge uchipora, chiremba wako anogona kukutumira kuchirongwa chekurapa mwoyo . Muzvirongwa izvi, vanachiremba, vanamukoti, varairidzi vekurovedza muviri, uye nyanzvi dzezvekudya vanoshanda pamwe chete kuti vakubatsire.
- Chii chinokuitira basa?
- Ndezvipi zvekudya zvaunofanira kudya?
- Nzira yekutora mushonga nemazvo sei?
- Ungararama sei hupenyu hune hutano zvakare?
Ndichakuudzai zvese zvinotaurwa.
Zvakare, zvakakosha kuenda kumisangano yekutevera yakapihwa nachiremba. Kutora mishonga yako nenguva, kudzora kudya kwako, uye kutevedzera mirairo yachiremba wako zvakakosha zvikuru kuti ukurumidze kupora uye kudzivirira kudzoka kwechirwere ichi.
Ndezvipi zvakanakira uye njodzi dzekurapa uku?
Sezvinoita chero kurapwa kupi zvako, nzira idzi dzine zvakanakira uye njodzi.
Ndezvipi zvakanakira?
- Kugona kuponesa hupenyu: Kurapa uku kunoponesa hupenyu muzviitiko zvakaita sekurwadziwa kwemoyo.
- Kudzivirira kurwara kwemoyo: Kana ukaona kuvharika kwetsinga dzeropa dzako nekukurumidza, unogona kudzivirira kurwara kwemoyo nekurapa kusati kwaitika.
- Kudzivirira mashandiro emoyo: Kana zvikarapwa nekukurumidza, kukuvara kwetsandanyama yemoyo kunogona kudzivirirwa zvachose kana kuderedzwa.
Ndezvipi njodzi nematambudziko?
Njodzi yacho inoenderana nekurapwa, zera rako, nezvimwe zvirwere zvaunazvo (zvakaita sechirwere cheshuga neBP).
| Nzira yekurapa | Njodzi dzakajairika |
|---|---|
| PCI (kuiswa kwestent) | Kukuvadzwa kwemwoyo kana tsinga dzeropa, kurova kwemoyo zvisina kurongeka (arrhythmias) , kuvharika kweropa, sitiroko, kana kubuda ropa. |
| CABG (Kuvhiyiwa kweBypass) | Njodzi dzinowanikwa pakuvhiyiwa. Semuenzaniso, kurwadziwa, kubuda ropa rakawanda, hutachiona hwemaronda. |
Asi usatya zvinhu izvi. Chiremba wako achakutsanangurira zvese zvakakwana uye achaedza zvese zvaanogona kuderedza njodzi dzako. Kana uine mibvunzo kana zvinokunetsa, bvunza chiremba wako nekukasika.
Zvinotora nguva yakareba sei kuti ndipore? Ndichafanira kuona chiremba zvakare riini?
Kunyange zvazvo uchigona kudzokera kuhupenyu hwako hwemazuva ese mukati memazuva mashoma mushure mePCI, zvinogona kutora mwedzi yakati wandei kuti unyatsopora kubva pakuvhiyiwa kweCABG. Chiremba wako achakuudza kuti unofanira kuzorora kwenguva yakareba sei, zvaunogona uye zvausingakwanise kuita.
Mushure mekurapwa, kana zviratidzo zvinotevera zvikaitika, unofanira kuona chiremba nekukasika .
- Kurwadziwa pachipfuva (Angina)
- Kutadza kufema zvakanaka (Dyspnea)
- Dzungu kana kunzwa kusuruvara
- Kurasikirwa nepfungwa
Zvakajairika kuti unzwe kutya uye kunetseka kana ukanzwa nezvedambudziko remwoyo. Zvisinei, kurapwa uku kunonzi Coronary Revascularization kunogona kugadzirisa matambudziko emwoyo zvakanyanya uye kudzivirira kuti asanyanya kuipa. Chinhu chakakosha kunzwisisa kurapwa uku nemazvo, kuwana rubatsiro rwechiremba runodiwa pasina kutya, uye kuedza kurarama hupenyu hune hutano uye hunofadza zvakare.
Mharidzo Yekuenda Nayo Kumba
- Kudzoreredza ropa mumoyo (coronary revascularization) zvinoreva kurapwa kunodzoreredza kuyerera kweropa mutsinga dzeropa dzakavharika mumoyo.
- PCI (kuiswa kwestent) uye CABG (kuvhiyiwa kwebypass) ndidzo nzira mbiri huru.
- Kurapa uku kunogona kudzivirira kurwara kwemoyo uye kuponesa hupenyu.
- Mushure mekurapwa, zvakakosha zvikuru kutevedzera mirairo yekurapa nemazvo, kunwa mishonga, kudzora kudya kwako, uye kurovedza muviri.
- Taura pachena nachiremba wako nezvekuti ndeipi nzira yekurapa yakanakira chirwere chako uye zvakanakira nezvayakaipira.
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